Abstract
BackgroundNegative symptoms represent an unmet therapeutic need in many patients with schizophrenia. In an extension to our previous voxel-based morphometry findings, we employed a more specific, vertex-based approach to explore cortical thinning in relation to persistent negative symptoms (PNS) in non-affective first-episode of psychosis (FEP) patients to advance our understanding of the pathophysiology of primary negative symptoms.MethodsThis study included 62 non-affective FEP patients and 60 non-clinical controls; 16 patients were identified with PNS (i.e., at least 1 primary negative symptom at moderate or greater severity sustained for at least 6 consecutive months). Using cortical thickness analyses, we explored for differences between PNS and non-PNS patients as well as between each patient group and healthy controls; cut-off threshold was set at p<0.01, corrected for multiple comparisons.ResultsA thinner cortex prominently in the right superior temporal gyrus extending into the temporo-parietal junction (TPJ), right parahippocampal gyrus, and left orbital frontal gyrus was identified in PNS patients vs. non-PNS patients. Compared with healthy controls, PNS patients showed a thinner cortex prominently in the right superior temporal gyrus, right parahippocampal gyrus, and right cingulate; non-PNS patients showed a thinner cortex prominently in the parahippocampal gyrus bi-laterally.ConclusionCortical thinning in the early stages of non-affective psychosis is present in the frontal and temporo-parietal regions in patients with PNS. With these brain regions strongly related to social cognitive functioning, our finding suggests a potential link between primary negative symptoms and social cognitive deficits through common brain etiologies.
Highlights
Cortical thinning in fronto-temporal regions has become a welldocumented finding in schizophrenia [1,2]
A significantly thinner cortex in the persistent negative symptoms (PNS) patients was observed in the following regions: bilateral frontal, temporal, fusiform, and occipital gyri, right parahippocampal gyrus, bi-lateral anterior cingulate, and right middle and posterior cingulate (Table 3; Figure 1)
The most prominent difference was observed in the right superior temporal gyrus extending into the temporo-parietal junction
Summary
Cortical thinning in fronto-temporal regions has become a welldocumented finding in schizophrenia [1,2]. Studies have shown cortical thinning related to symptomology during these early stages of illness, the relationship with negative symptoms remains vague with some studies identifying an association [6,7,8] and others not [3,9] The ambiguity of these findings may be due to the fact that not all studies explicitly explored primary negative symptoms. In an extension to our previous voxel-based morphometry findings, we employed a more specific, vertex-based approach to explore cortical thinning in relation to persistent negative symptoms (PNS) in non-affective first-episode of psychosis (FEP) patients to advance our understanding of the pathophysiology of primary negative symptoms
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